【摘要】基于正念的计划（MBP）被广泛用于预防精神疾病。证据表明，平均效应是有益的，但变异性很大。我们的目的是确认MBP的效果，并了解基线痛苦、性别、年龄、教育和性格正念是否以及如何改变MBP对非临床环境中成年人的痛苦的影响。 我们进行了系统回顾和个体参与者数据（IPD）荟萃分析（PROSPERO CRD42020200117）。2020年12月，我们在数据库中检索了满足质量阈值的随机对照试验，并将专家定义的现场MBP与被动对照组进行比较。两名研究人员使用修订后的 Cochrane 偏倚风险工具独立选择、提取和评估试验。向作者寻求合格试验的IPD。 主要结局是项目完成后1至6个月的心理困扰（不愉快的精神或情感经历，包括焦虑和抑郁）。检查数据并估算缺失情况。进行了配对、随机效应、两阶段IPD荟萃分析。效果修改分析遵循研究内方法。利益相关者参与了整个研究，十五项试验符合条件。13名试验者共享IPD（代表8个国家的2,371名参与者）。与被动对照组相比，MBP减少了干预后1至6个月的平均痛苦，效果大小为小到中等（标准化平均差，-0.32；95% 置信区间），-0.41至-0.24；P < 0.001；无异质性）。结果对敏感性分析稳健，并且与其他时间点范围相似。主要结局结果的置信度很高。我们没有发现明确的迹象表明这种效应会出现咋预先指定的候选人身上。以小组为基础的教师主导的MBP通常可以减少志愿服务社区成年人的心理困扰。但是，需要更多的研究来确定个人层面结果变异的来源。 

   [Abstract] Mindfulness-based programs (MBPs) are widely used to prevent mental ill health. Evidence suggests beneficial average effects but wide variability. We aimed to confirm the effect of MBPs and to understand whether and how baseline distress, gender, age, education, and dispositional mindfulness modify the effect of MBPs on distress among adults in non-clinical settings. We conducted a systematic review and individual participant data (IPD) meta-analysis (PROSPERO CRD42020200117). Databases were searched in December 2020 for randomized controlled trials satisfying a quality threshold and comparing in-person, expert-defined MBPs with passive-control groups. Two researchers independently selected, extracted and appraised trials using the revised Cochrane Risk-of-Bias tool. IPD of eligible trials were sought from authors. The primary outcome was psychological distress (unpleasant mental or emotional experiences including anxiety and depression) at 1 to 6 months after program completion. Data were checked and imputed if missing. Pairwise, random-effects, two-stage IPD meta-analyses were conducted. Effect modification analyses followed a within-studies approach. Stakeholders were involved throughout this study. Fifteen trials were eligible; 13 trialists shared IPD (2,371 participants representing 8 countries. In comparison with passive-control groups, MBPs reduced average distress between 1 and 6 months post-intervention with a small to moderate effect size (standardized mean difference, −0.32; 95% confidence interval, −0.41 to −0.24; P < 0.001; no heterogeneity). Results were robust to sensitivity analyses and similar for the other timepoint ranges. Confidence in the primary outcome result is high. We found no clear indication that this effect is modified by the pre-specified candidates. Group-based teacher-led MBPs generally reduce psychological distress among volunteering community adults. More research is needed to identify sources of variability in outcomes at an individual level.

论文原文：Julieta Galante, Claire Friedrich, Tim Dalgleish, Peter B. Jones & Ian R. White (2023). Systematic review and individual participant data meta-analysis of randomized controlled trials assessing mindfulness-based programs for mental health promotion. Nature-Mental Health, 1(7): 462–476. Published: 10 July 2023

https://doi.org/10.1038/s44220-023-00081-5

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